DE102005010458A1 - Endoscope Mouthpiece - Google Patents

Abstract

The invention relates to a mouthpiece (2) for use in upper endoscopy, which has a main body (3) which is generally tubular and inside a passage for an insertion tube (1) of an endoscope and on the outer circumference of the passage portion a tooth abutment portion (3a ) having. The inner passage in the main body (3) is provided with an intermediate plate (4), whereby the inner passage is divided into an upper passage (5) for insertion of an insertion tube (1) of an endoscope and a lower passage (6) for receiving and adapted to hold the tongue (B) of a patient in such a way that tongue movements are restricted.

Description

BACKGROUND THE INVENTION

Technical area

The The present invention relates to an endoscope mouthpiece, and more particularly on a mouthpiece for use in upper endoscopy, for example for use in the endoscopic examination of the upper digestive tract, the prevents a patient from reaching the insertion tube an endoscope with his or her teeth when the insertion tube through the mouth the pharynx is introduced to a site of interest in a body cavity.

endoscopes for the upper digestive tract, such as gastroscopes and duodenoscopes are with an elongated one insertion tube equipped with flexible construction, that along an introduction route free is bendable and is introduced orally through the throat and esophagus, when a location in a cavity is to be examined. At the introduction it is necessary to the oral cavity forcibly keeping the patient in an open state, otherwise the patient would bite on the insertion tube, which damage on the outer surfaces of the insertion tube and in some cases the introduction of the endoscope. It is therefore common practice in the Mouth of the patient a mouthpiece use it to keep your teeth of the patient from a direct contact with the insertion tube Keep away from an endoscope.

One between the teeth a patient endoscope mouthpiece is generally tubular and inside it is provided with a tunnel-like passage, the one insertion tube an endoscope. So that a patient the mouthpiece stable in his or her mouth reserves, the mouthpiece is not formed in a simple tube shape, but usually expands from a region of smallest diameter, between the Teeth of the Patients is to the front end and to the back End. It follows that, even if an external force on the mouthpiece in the direction of the outside or exercised inside will, the mouthpiece does not become unstable or fall out of the patient's mouth.

in the In view of this, a patient feels when an insertion tube of an endoscope into the throat of a patient via a mouthpiece, the placed in the patient's mouth, is introduced, nausea, if that insertion tube pushed through the throat. The nausea is triggered when the insertion tube pushed upwards by movements of the patient's tongue and is brought into contact with the upper jaw. It is therefore necessary that mouthpiece is able to hold down the patient's tongue while one insertion tube an endoscope is inserted through the throat. For this purpose, attempts were made made a plate-shaped Tongue holder on the body to provide an endoscope mouthpiece, such as in Japanese Patent Application Laid-open S55-101 is disclosed.

Even if a tongue plate is provided extending from the body of a mouthpiece extends as in the above-mentioned Prior art has been proposed, its length is limited. If the tongue holder on the mouthpiece so far protruding that he holds the tongue root area, the Tongue holder contracting by pressing down the tongue of the pharynx when the mouthpiece is in the mouth of a patient is used. Consequently, the long tongue holder can introduce a insertion tube complicate an endoscope through the throat of a patient and greater pain on the part of the patient cause the nausea is even more amplified. Therefore, a tongue holder of an unsuitable length can be just the opposite Effect, that is, not to reduce the nausea, the one Patient suffers when he puts an endoscope mouthpiece in his mouth.

SUMMARY THE INVENTION

In In view of the above Conditions, it is an object of the present invention, a Endoscope mouthpiece which are used for upper endoscopy in the mouth of a patient It is intended to indicate that it is designed to be a smooth passage an insertion tube of a Endoscopes allowed without causing nausea in the patient becomes.

A Another object of the present invention is to provide an endoscope mouthpiece, which is designed such that an insertion tube of an endoscope gently and easily inserted through the throat of a patient, without pain on the part of the patient.

The The above underlying object is achieved according to claim 1.

The dependent claims refer to preferred embodiments of the invention.

According to the present invention and to In order to achieve the above-mentioned objects, there is provided an endoscope mouthpiece having a main body which is generally tubular and internally defines a passageway for an insertion tube of an endoscope and externally has a teeth abutment portion on the outer periphery of the passageway; it is characterized in that the mouthpiece comprises: an intermediate plate provided in the passage and transversely therein dividing it into a first or upper passage and a second or lower passage, the upper passage being formed to serve as a passage can serve for an insertion tube of an endoscope, and the lower passage is formed so that it can receive the tongue of a patient so that it limits movements of the tongue.

The mouthpiece is designed so that it moves the patient's tongue in effectively restricted, as soon as it is put into the second passage under the first passage, whereby in particular upward movements of the Tongue in which there is a tendency for an insertion tube of an endoscope pushed upwards becomes, minimizes and suppresses become. In a preferred form of the present invention extends a tongue holder to stabilize the tongue, in the second Passage is defined, from the intermediate plate over a proximal stop end of the mouthpiece. According to the general procedure at upper endoscopy lies a patient or a patient during an investigation on the left side. It is therefore favorable to the Tongue holding section compared to the second, lower passage form with a smaller width and shape so that the tongue holding section reduced width is inclined down when a patient has a lying position. In this case, part of the tongue of the patient, who are not admitted in the second pass can, in open spaces on the opposite side Side of the tongue holding section are added. For this purpose reduced the width of the tongue holding portion progressively and continuously towards the proximal free end by one side of the tongue holding section diagonally to the other side is cut. The patient's tongue in the second pass becomes moved towards an open space on the lower side, resulting in a room on the upper side of the second Passage opens, to facilitate the patient's breathing. After another preferred form of the present invention is also a guide rib up and down the intermediate plate and the tongue holding portion on the side of the first, upper passage provided, creating an insertion tube an endoscope through a central region of the first passage safely guided can be. Further, if necessary, a hole for injecting of liquids be drilled through the intermediate plate to an anesthetic or other medical fluids inject.

The above and other objects, features and advantages of the present invention The invention will become apparent from the following detailed description the invention in conjunction with the accompanying drawings, which by way of example some preferred embodiments of the invention demonstrate. Of course, the present invention is not be interpreted as being limited to certain forms which are shown in the drawings.

SHORT DESCRIPTION THE DRAWINGS

From the attached Drawings show:

1 a schematic sectional view of an endoscope mouthpiece, which is inserted in the mouth of a patient, and an insertion tube of an endoscope, which is inserted into the throat of the patient through the mouthpiece;

2 a schematic perspective view of the in 1 illustrated mouthpiece;

3 a schematic plan view of the in 1 illustrated mouthpiece;

4 a schematic rear view of the in 1 illustrated mouthpiece;

5 a side view of the in 1 illustrated mouthpiece from the right;

6 a schematic representation for explaining how the tongue of a patient is held by the mouthpiece in a restricted state;

7 a view similar 2 but showing a modification of the mouthpiece;

8th a view similar 3 but showing a further modification of the mouthpiece, and

9 a view similar 4 which, however, shows a further modification of the mouthpiece.

DESCRIPTION PREFERRED EMBODIMENTS

In the following, the present invention is explained in more detail with reference to the accompanying drawings with reference to preferred embodiments. First, it will open 1 Reference is made; she shows an endoscope mouthpiece according to the present invention and an insertion tube of an endoscope, which is inserted through the mouthpiece into the throat of a patient.

In 1 means 1 an insertion tube of an endoscope, and 2 denotes a mouthpiece. The mouthpiece 2 is placed in the mouth of a patient so that it can be grasped between the patient's teeth. Through the mouthpiece 2 through is the insertion tube 1 of the endoscope inserted through the pharynx T into the esophagus E.

The mouthpiece 2 has a main body 3 on, which is generally tubular. As in the 2 to 5 is shown, is the mouthpiece 2 in a longitudinally central portion of the main body 3 with a dental rest section 3a and a front end portion of the main body 3 in front of the dental rest section 3a Mistake; in other words, a front end portion that faces the front of the patient's lips expands in a funnel-like shape, thus giving an entrance 3b of the mouthpiece 2 in front. The other, rear end, which is in the mouth M, is slightly flared, thus creating a stop area 3c , This way is the main body 3 of the mouthpiece 2 designed so that it in the tooth support section 3a having the smallest diameter. Therefore, when the mouthpiece 2 is inserted into the mouth M of a patient, the Zahnauflageabschnitt 3a between the teeth D of the patient firmly grasped, so that the mouthpiece 2 stable and in particular in the direction inwards and outwards in a stationary state in the mouth M is maintained.

In particular, the tubular main body 3 of the mouthpiece 2 between the flared front end 3a and the flared rear end 3c formed so that it has an elliptical cross-sectional shape, and an intermediate plate 4 is disposed transversely across an elliptical inner passageway approximately at an intermediate position in the direction of the long axis of the elliptical passage, which forms the elliptical passageway into an upper passageway 5 and a lower passage 6 Splits. The elliptical inner passage within the main body 3 of the mouthpiece 2 is so through the intermediate plate 4 divided into a first passage 5 which is on the upper side, and a second passage 6 which is on the lower side. The first passage 5 is as a passage for an insertion tube 1 an endoscope provided during the second pass 6 as a pocket for receiving the tongue of a patient through the inner stop end 3c of the mouthpiece 2 through it serves. The intermediate plate 4 that the first passage 5 and the second passage 6 in the mouthpiece, stands on the proximal side of the stop end 3c over a predetermined length and thus results in a tongue holding section 7 at the innermost free end of the intermediate plate 4 ,

In this example, the intermediate plate 4 in an intermediate position between the funnel-like entrance end 3b and the stopper 3c over a predetermined length with the inner surfaces of the tubular main body 3 of the mouthpiece 2 connected by the size of the mouthpiece 2 depends, however, not connected to the inner surfaces of the main body of a transition area from the transition to the tongue holding portion 7 at the innermost free end. Therefore, a clearance V remains on each side of the intermediate plate 4 over a given length. The tongue holding section 7 must be of a certain length so that it can function as a tongue holder; however, it should have a length that ends just before the throat T.

In use, the mouthpiece 2 of the construction described above prior to insertion of an endoscope into the mouth of a patient who has to undergo an upper endoscopy. The mouthpiece 2 can by pressing the main body 3 of the mouthpiece 2 in the mouth M in until the Zahnauflageabschnitt 3a between the teeth of the patient is positioned. Then the tongue holding section can 7 as an extension of the intermediate plate 4 is intended to penetrate into a deeper area of the mouth M. By extending the tongue under the tongue holding section 7 the patient's tongue enters the second passage 6 on the lower side of the first passage 5 of the mouthpiece 2 introduced and detained there. In this case, the patient or the patient is urged, the tip of his or her tongue as far as possible in the second passage 6 hineinzustecken. The cross-sectional area of the tongue increases toward the tongue root area and becomes larger than the cross-sectional area of the second passage 6 , However, since the gaps V on the opposite sides of the intermediate plate 4 are provided, the inner or rear portion not with the inner surfaces of the expanding stop end 3c connected and spaced therefrom, opposite side portions of the tongue are received in the gaps V. As a result, the tongue can be independent of the increase in its cross-sectional area in the second passage 6 in a non-tensioned condition and taken over a sufficient length to restrict movements of the tongue. Behind the second passage 6 the tongue lies under the tongue holding section 7 at the main body 3 of the mouthpiece. Therefore, the tongue is effectively restricted in its movements, particularly with respect to upward, downward, right and left movements.

An endoscopic examination usually involves a patient lying sideways. Therefore, gravity acts constantly on the tongue of the patient. When movements of the tongue through the second passage 6 would be very cumbersome for the patient, which would greatly increase the tension on the part of the patient. Therefore, if endoscopic examination takes a long time, a patient would be fatigued considerably. However, since the empty spaces V in the second passage 6 open, the patient's tongue B can move into the empty spaces V, as shown in FIG 6 is shown without the possibility of disturbing the introduction tube 1 of the endoscope in the first pass 5 given the mouthpiece. Accordingly, the patient's tongue B on the back side BB becomes through the wide wall surfaces of the mouthpiece of the second passageway 6 supported to a position after the empty space V. Therefore, the tongue B is stored in a stabilized state and with a certain degree of freedom for movement, whereby the tension and fatigue on the part of the patient are reduced to a significant extent.

After insertion of the mouthpiece into the mouth of the patient becomes the insertion tube 1 of the endoscope in the first pass 5 of the mouthpiece 2 introduced. The insertion tube 1 is held without contact with the tongue until it passes over the tongue holding section 7 is introduced. This means that the tongue will not receive any stimuli from the insertion tube until this point and remain essentially in a motionless state. If the insertion tube 1 of the endoscope toward the throat T via the tongue holding section 7 is pushed out, an inward pressure force is exerted on the throat T. However, since the throat T can be passed within a short length and the tip of the tongue is in a forced restricted state with respect to movements, otherwise by stimulating contact with the insertion tube 1 would be irritated, the root portion of the tongue remains motionless and is through the insertion tube 1 of the endoscope is not pushed up against the upper jaw. If the insertion tube 1 Once the endoscope passes through the pharynx T, there is little possibility of irritation of the tongue due to inward movement of the introducer tube 1 of the endoscope, and nausea and pain on the part of the patient are reduced to a minimum level. Accordingly, the insertion tube 1 of the endoscope are gently inserted into a body cavity of interest without disturbing the patient's tongue.

According to the procedure of upper endoscopy, the patient is placed on one side of a bed during an examination, usually on the left side. Therefore, there is a tendency when the introduction tube 1 of the endoscope straight into the first pass 5 of the main body 3 of the mouthpiece 2 , which is located in the mouth of the patient lying, that introduces the insertion tube 1 towards a corner of the first passage 5 along a lower curved portion of the first passage 5 , In such a case, the maneuverability of the introduction tube 1 are deteriorated by lateral sliding, causing difficulty in the rapid introduction of the front end of the insertion tube 1 into the esophagus E from the pharynx.

To overcome the difficulties mentioned above is at a in 7 illustrated modification to the intermediate plate 4 on the side of the first round 5 of the mouthpiece 2 a leadership rib 10 provided as far as the tongue holding section 7 extends. In this case, the arrangement is such that the upper end of the guide rib 10 from the inner wall on the upper side of the first passage 5 is spaced by a gap which is smaller than the outer diameter of the introduction tube 1 , If the leadership rib 10 is arranged in this way, the introduction tube 1 of the endoscope along the guide rib 10 guided and passes substantially through the central region of the first passage 5 through, as in 7 dash-dotted lines is shown. Therefore, thanks to the reduction of the resistance to lateral sliding, it becomes easier the movements of the introduction tube 1 of the endoscope during rapid insertion on the pharynx.

If the mouthpiece 2 is inserted into the mouth of a patient, the patient's tongue is further in the second passage 6 to the bottom or left side of the second pass 6 postponed. In such a state, it is not necessarily required that an upper portion of the tongue holding portion 7 the tongue holds, and an upper portion thereof may, if desired, be cut away to form a tongue holding portion 7 ' to achieve approximately triangular shape, as in 8th is shown. In this case, the tongue of the patient, as it enters the second passage 6 into the lower side of the passage 6 and opens more or less free space in an upper area of the second passage 6 which can serve as a breathing hole to facilitate the patient's breathing.

Furthermore, as shown in 9 is shown, a hole 11 be provided for the injection of liquids, through the intermediate plate 4 and the tongue holding section 7 of the mouthpiece 2 passes and for injecting an anesthetic or other medicinal liquid in the mouth or throat T out hin serves.

1

insertion tube

2

mouthpiece

3

main body

3a

Tooth bearing section

3b

Entrance opening, funnel-shaped

3c

Stop area, stop end

4

intermediate plate

5

upper Passage (first passage)

6

lower Passage (second passage)

7, 7 '

Tongue retaining section

10

guide rib

11

hole for injecting liquids

B

tongue

BB

back

D

teeth

e

esophagus

M

mouth

T

throat

V

gap

Claims (9)

Endoscope mouthpiece ( 2 ), which has a main body ( 3 ), which is generally tubular in shape and inside a passage for an insertion tube ( 1 ) of an endoscope and externally a tooth support section ( 3a ) on the outer circumference of this passage, characterized in that the mouthpiece ( 2 ): an intermediate plate ( 4 ), which is provided in this passage and transversely therein and into an upper passage ( 5 ) and a lower passage ( 6 ), the upper passage ( 5 ) is designed so that it serves as a passage for an insertion tube ( 1 ) of an endoscope, and the lower passage ( 6 ) is adapted to receive the tongue (B) of a patient so as to restrict movements of the tongue (B). Endoscope mouthpiece ( 2 ) according to claim 1, wherein the main body ( 3 ) is formed so that it at the tooth support portion ( 3a ) has the smallest diameter, and with a funnel-shaped, conically widened end ( 3 ), which is then connected to the front of the passage as an input for an insertion tube ( 1 ) is formed of an endoscope, and a slightly flared end ( 3c ), which subsequently adjoins the proximal side of the tooth support section (FIG. 3a ) is designed as a stop area which is to be inserted into the mouth (M) of a patient. Endoscope mouthpiece ( 2 ) according to claim 1 or 2, wherein the main body ( 3 ) of the mouthpiece ( 2 ) is formed in cross-section in an elliptical shape and the intermediate plate ( 4 ) is along the long axis of an elliptical cross-sectional area, which is the passage in an upper passage ( 5 ) and a lower passage ( 6 ) Splits. Endoscope mouthpiece ( 2 ) according to one of claims 1 to 3, further comprising a tongue holding portion ( 7 . 7 ' ), which is provided so that it extends from the intermediate plate ( 4 ) over the stop area ( 3c ) extends to the rear. Endoscope mouthpiece ( 2 ) according to claim 4, in which the tongue holding section ( 7 . 7 ' ) from the intermediate plate ( 4 ) extends rearwardly in a width which is smaller than the second, lower passage ( 6 ). Endoscope mouthpiece ( 2 ) according to claim 4 or 5, wherein one side of the tongue holding section ( 7 . 7 ' ) is inclined towards the other side in such a way that the width of the tongue holding portion ( 7 . 7 ' ) progressively decreases toward the posterior, distal end. Endoscope mouthpiece ( 2 ) according to one or more of claims 1 to 6, in which at least on one surface of the intermediate plate ( 4 ) on the side of the first, upper passage ( 5 ) a leadership rib ( 10 ), which serves to provide an insertion tube ( 1 ) of an endoscope in the right direction. Endoscope mouthpiece ( 2 ) according to claim 7, wherein the space between the upper end of the guide rib ( 10 ) on the intermediate plate ( 4 ) and the ceiling wall of the first upper passage ( 5 ) is smaller than the outer diameter of the introduction tube ( 1 ) of the endoscope. Endoscope mouthpiece ( 2 ) according to one or more of claims 1 to 8, further comprising a hole ( 11 ) for injecting liquids through the intermediate plate ( 4 ) and the tongue holding section ( 7 . 7 ' ) of the mouthpiece ( 2 ) goes through.